Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
Juliette De Avila,
Cristian Flórez-Sarmiento,
Viviana Parra-Izquierdo,
Wilson Bautista-Molano,
Magaly Chamorro-Melo,
Adriana Beltrán-Ostos,
Diego Alejandro Jaimes,
Valery Khoury,
Lorena Chila-Moreno,
Alejandro Ramos-Casallas,
Juan Manuel Bello-Gualtero,
Jaiber Gutiérrez,
Cesar Pacheco-Tena,
Philippe Selim Chalem Choueka,
Consuelo Romero-Sánchez
Affiliations
Juliette De Avila
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Cristian Flórez-Sarmiento
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Viviana Parra-Izquierdo
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Wilson Bautista-Molano
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Magaly Chamorro-Melo
Clinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, Colombia
Adriana Beltrán-Ostos
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Diego Alejandro Jaimes
Clínicos IPS, Bogotá 110231, Colombia
Valery Khoury
School of Medicine, Universidad El Bosque, Bogotá 110121, Colombia
Lorena Chila-Moreno
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Alejandro Ramos-Casallas
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Juan Manuel Bello-Gualtero
Clinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, Colombia
Jaiber Gutiérrez
Clinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, Colombia
Cesar Pacheco-Tena
Investigación y Biomedicina de Chihuahua, Chihuahua 31205, Mexico
Philippe Selim Chalem Choueka
Fundación Instituto de Reumatología Fernando Chalem, Bogotá 111211, Colombia
Consuelo Romero-Sánchez
Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, Colombia
Objective: This study aimed to establish a correlation between fecal calprotectin levels (FC) and intestinal inflammation in patients with spondyloarthritis without inflammatory bowel disease. Methods: A total of 180 SpA patients were included in the study of them 20.6% required Digital chromoendoscopy (DCE). FC, C-reactive protein (CRP), HLA-B*27 and clinical indices were assessed. Results: Positive fecal calprotectin (PFC) and high fecal calprotectin (HFC) levels were observed in 27.0% and 16.0% of patients, respectively. HFC correlated with a Bath Ankylosing Spondylitis Functional Index (BASFI) score > 4.0 (p = 0.036) and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score > 4.0 (p = 0.047). Loss of vascular pattern in the ileum (LVPI) was observed in approximately 70.0% of patients (p = 0.005), which was associated with PFC and abdominal bloating (p = 0.020). LVPI was also linked to microscopic inflammation (p = 0.012) and PFC with abdominal pain (p = 0.007). HFC was significantly associated with alterations in the ileal mucosa (p = 0.009) and LVPI (p = 0.001). Additionally, HFC and diarrhea were associated with LVPI in 27.3% of patients (p = 0.037) and with erosions in the ileum (p = 0.031). Chronic ileal inflammation correlated with HFC (p = 0.015), ASDAS-CRP > 2.1 (p = 0.09), LVPI (p = 0.001), and villous atrophy (p = 0.014). Factorial analysis of mixed data (FAMD) identified significant associations between micro/macroscopic changes in chronic inflammation and HFC (CC = 0.837); increased levels of CRP and microscopic acute inflammation (CC = 0.792); and clinical activity scores of ASDAS-CRP and BASDAI (CC = 0.914). Conlusions: FC levels were significantly elevated in patients with SpA, particularly those with LVPI, suggesting their potential as a valuable biomarker for managing SpA when joint manifestations coincide with ileal villous atrophy. This indicates a shared immune pathway linked to chronic gut damage.
